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Lepe A, Hoveling LA, Boissonneault M, de Beer JAA, Reijneveld SA, de Kroon MLA, Liefbroer AC. Educational inequalities in major depressive disorder prevalence, timing and duration among adults over the life course: a microsimulation analysis based on the Lifelines Cohort Study. Eur J Public Health 2024; 34:723-729. [PMID: 38614471 PMCID: PMC11293816 DOI: 10.1093/eurpub/ckae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Educational inequalities in major depressive disorder (MDD) pose a major challenge. Tackling this issue requires evidence on the long-term impact of intervening on modifiable factors, for example lifestyle and psychosocial factors. For this reason, we aimed to simulate the development of educational inequalities in MDD across the life course, and to estimate the potential impact of intervening on modifiable factors. METHODS We used data from the prospective Dutch Lifelines Cohort Study to estimate the required input for a continuous-time microsimulation. The microsimulation allowed us to project the development of educational inequalities in MDD between ages 18 and 65, and to assess the potential benefit of intervening on quality of social contacts, health literacy and smoking. RESULTS On average, an additional 19.1% of individuals with low education will ever experience MDD between ages 18 and 65 compared with those with high education. Additionally, individuals with low education generally will develop MDD 0.9 years earlier and spend 1.2 years more with MDD, than individuals with high education. Improving the quality of social contacts in individuals with low education produced the largest effect; it would reduce the inequalities in the prevalence, onset and duration of MDD by an average of 18.4%, 18.3% and 28.6%, respectively. CONCLUSIONS Intervening on modifiable factors, particularly quality of social contacts, in individuals with low education could help reduce the estimated educational inequalities in MDD over the life course.
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Affiliation(s)
- Alexander Lepe
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Liza A Hoveling
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Michaël Boissonneault
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW, University of Groningen, The Hague, The Netherlands
| | - Joop A A de Beer
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW, University of Groningen, The Hague, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marlou L A de Kroon
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Aart C Liefbroer
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW, University of Groningen, The Hague, The Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Liu T, Wang L, Zhu Z, Wang B, Lu Z, Pan Y, Sun L. Association of both depressive symptoms scores and specific depressive symptoms with all-cause and cardiovascular disease mortality. Ann Gen Psychiatry 2024; 23:25. [PMID: 39010080 PMCID: PMC11250981 DOI: 10.1186/s12991-024-00509-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 06/14/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND The presence of depression related to an increased risk of all-cause and cardiovascular disease (CVD) mortality has been reported. However, studies conducted on certain specific depressive symptoms are scarce. Our purpose was to assess the effect of both depressive symptoms scores and certain specific depressive symptoms on all-cause and CVD mortality. METHODS In the present cohort study, all participants, aged 18 years or older, were enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014. Depressive symptoms score was assessed using the validated 9-item Patient Health Questionnaire Depression Scale (PHQ-9), which ranges from 0 to 27, with a PHQ-9 score ≥ 10 diagnosed as depression. The outcome events were all-cause and CVD mortality, which were followed up from 2005 to 2014. The associations of both depressive symptoms score and certain specific depressive symptoms with all-cause and CVD mortality were examined by weighted multivariable proportional hazards models. RESULTS A total of 26,028 participants aged ≥ 18 years were included in the statistical analysis, including 12,813 (49.2%) males and 13,215 (50.8%) females, with a mean (SD) age of 47.34 (18.86) years. During the 9.32 (3.20) years of mean (SD) follow-up, 3261 deaths were recorded, of which 826 were cardiovascular deaths. All-cause mortality was 16.87/1000 person-years in subjects with depression. In terms of CVD mortality, these figures were 4.53/1000 person-years. In the full model (model 3), elevated depressive symptoms scores were independently associated with an increased risk of all-cause mortality (Highest depression symptom score group: adjusted hazard ratio, 1.63; 95% CI 1.44-1.85) and CVD mortality (Highest depression symptom score group: adjusted hazard ratio, 1.73; 95% CI 1.34-2.24). All 9 specific depressive symptoms that make up the PHQ-9 were related to an increased risk of all-cause mortality. However, only 3 symptoms, including trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation, were no significantly associated with an increased risk of CVD mortality. CONCLUSIONS The elevated depressive symptoms scores were strongly associated with an increased risk of all-cause and CVD mortality in US adults. Furthermore, all 9 specific depressive symptoms were associated with high all-cause mortality. However, trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation might not increase the risk of CVD mortality.
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Affiliation(s)
- Tao Liu
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Lili Wang
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhijian Zhu
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Bing Wang
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Zhigang Lu
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yesheng Pan
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
| | - Lifang Sun
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
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Kim S, Kim MS, Kim J, Kim JS, Hong SB. Attention-deficit/hyperactivity disorder and subsequent diagnoses of major psychiatric disorders: a nationwide population-based study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02497-5. [PMID: 38958762 DOI: 10.1007/s00787-024-02497-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 06/07/2024] [Indexed: 07/04/2024]
Abstract
We evaluated the risk of being diagnosed with various psychiatric disorders after an attention-deficit/hyperactivity disorder (ADHD) diagnosis using data from South Korea's National Health Insurance Service from 2002 to 2019, which covers approximately 97% of the country's population. ADHD and control groups were selected after propensity score matching was performed for individuals diagnosed with ADHD and their age- and sex-matched counterparts from the general population. Comorbid psychiatric disorders included depressive disorder, bipolar disorder, tic disorder, and schizophrenia. The incidence of newly diagnosed psychiatric disorders was compared between the groups. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated and adjusted for ADHD medication prescription. After matching, 353,898 individuals were assigned to each of the two groups. Compared to the control group, the ADHD group showed a significantly higher risk of being subsequently diagnosed with depressive disorder, bipolar disorder, schizophrenia, and tic disorder. The onset age of depressive disorder, bipolar disorder, and schizophrenia in the ADHD group was 16-17 years, approximately 5 years earlier than that in the control group. The risk for depression was the highest in individuals with high income levels, and that for schizophrenia was the highest among rural patients. The median length of the follow-up time until the diagnosis of each comorbid psychiatric disorder was 7.53, 8.43, 8.53, and 8.34 years for depressive disorder, bipolar disorder, schizophrenia, and tic disorder, respectively. Individuals with ADHD had an overall higher risk of being diagnosed with subsequent psychiatric disorders than did the controls. Hence, they should be carefully screened for other psychiatric symptoms from an early age and followed up for an extended duration, along with appropriate interventions for ADHD symptoms, including psychosocial treatments and educational approaches.
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Affiliation(s)
- Sujin Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Mi-Sook Kim
- Medical Research Collaborating Center, Biomedical Research Institution, Seoul National University Hospital, Seoul, Korea
| | - Jinhee Kim
- Medical Research Collaborating Center, Biomedical Research Institution, Seoul National University Hospital, Seoul, Korea
| | - Jae Sung Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Soon-Beom Hong
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea.
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea.
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Tang Z, Yang X, Tan W, Ke Y, Kou C, Zhang M, Liu L, Zhang Y, Li X, Li W, Wang SB. Patterns of unhealthy lifestyle and their associations with depressive and anxiety symptoms among Chinese young adults: A latent class analysis. J Affect Disord 2024; 352:267-277. [PMID: 38378090 DOI: 10.1016/j.jad.2024.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND There is little evidence on the association between patterns of unhealthy lifestyle and mental health among young adults. METHOD This study included a total of 28,978 young adults aged 18 to 44 years old in Guangdong province in south China, which was conducted from September to December in 2022. We used latent class analysis to classify the patterns of unhealthy lifestyle among young adults and used multiple logistic regression to explore their associations with depressive and anxiety symptoms. RESULT The weighted prevalence of depressive and anxiety symptoms were 28.0 % and 19.5 %, respectively. The cumulative effect of unhealthy lifestyles on depressive and anxiety symptoms was significant. Five patterns of unhealthy lifestyle were classified. Compared to the relatively healthy lifestyle class, the class with more unhealthy lifestyles (OR = 6.54, 95 % CI: 5.70-7.51) and insufficient sleep (OR = 6.16, 95 % CI: 4.92-7.70) had higher risk for depressive and anxiety symptoms. Meaningfully, having adequate mental health literacy could reduce the risk of depressive and anxiety symptoms from unhealthy lifestyle by half. LIMITATIONS The cross-section design study limited causal inferences, and the self-report information may lead to recall bias. CONCLUSIONS Unhealthy lifestyles have a negative impact on depressive and anxiety symptoms through independent, cumulative and combined effects, and they could be interrelated. Unhealthy lifestyle patterns differed in younger population by socio-demographic characteristics and mental health literacy. Health-care professionals and policymakers may provide programs to intervene multiple unhealthy lifestyles and improve mental health literacy by integrating healthy lifestyle education to promote youngers' mental health.
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Affiliation(s)
- Zhitao Tang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Xinyan Yang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Wenyan Tan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yunfei Ke
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Min Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Lijie Liu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Yali Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Xue Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China.
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China; School of Health, Zhuhai College of Science and Technology, Zhuhai, Guangdong Province, China.
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Culpepper L, Martin A, Nabulsi N, Parikh M. The Humanistic and Economic Burden Associated with Major Depressive Disorder: A Retrospective Cross-Sectional Analysis. Adv Ther 2024; 41:1860-1884. [PMID: 38466558 PMCID: PMC11052813 DOI: 10.1007/s12325-024-02817-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/07/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Major depressive disorder (MDD) is a debilitating and costly condition. This analysis characterized the health-related quality of life (HRQoL), health care resource utilization (HCRU), and costs between patients with versus without MDD, and across MDD severity levels. METHODS The 2019 National Health and Wellness Survey was used to identify adults with MDD, who were stratified by disease severity (minimal/mild, moderate, moderately severe, severe), and those without MDD. Outcomes included HRQoL (Short Form-36v2 Health Survey, EuroQol Five-Dimension Visual Analogue Scale, utility scores), HCRU (hospitalizations, emergency department [ED] visits, health care provider [HCP] visits), and annualized average direct medical and indirect (workplace) costs. A subgroup analysis was conducted in participants with MDD and prior medication treatment failure. Participant characteristics and study outcomes were evaluated using bivariate analyses and multivariable regression models, respectively. RESULTS Cohorts comprised 10,710 participants with MDD (minimal/mild = 5905; moderate = 2206; moderately severe = 1565; severe = 1034) and 52,687 participants without MDD. Participants with MDD had significantly lower HRQoL scores than those without (each comparison, P < 0.001). Increasing MDD severity was associated with decreasing HRQoL. Relative to participants without MDD, participants with MDD reported more HCP visits (2.72 vs 5.64; P < 0.001) and ED visits (0.18 vs 0.22; P < 0.001) but a similar number of hospitalizations. HCRU increased with increasing MDD severity. Although most patients with MDD had minimal/mild to moderate severity, total direct medical and indirect costs were significantly higher for participants with versus without MDD ($8814 vs $6072 and $5425 vs $3085, respectively, both P < 0.001). Direct and indirect costs were significantly higher across all severity levels versus minimal/mild MDD (each comparison, P < 0.05). Among patients with prior MDD medication treatment failure (n = 1077), increasing severity was associated with significantly lower HRQoL and higher total indirect costs than minimal/mild MDD. CONCLUSION These results quantify the significant and diverse burdens associated with MDD and prior MDD medication treatment failure.
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Affiliation(s)
- Larry Culpepper
- Department of Family Medicine, Boston University School of Medicine, 90 Sylvia Ln, Westport, MA, 02790-1406, USA.
| | - Ashley Martin
- Health Economics and Outcomes Research, Cerner Enviza, New York, NY, USA
| | - Nadia Nabulsi
- Health Economics and Outcomes Research, AbbVie, North Chicago, IL, USA
| | - Mousam Parikh
- Health Economics and Outcomes Research, AbbVie, Florham Park, NJ, USA
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Dong C, Wang Z, Jia F, Tian H, Zhang Y, Liu H, Yu X, Wang L, Fu Y. Gender differences in the association between childhood maltreatment and the onset of major depressive disorder. J Affect Disord 2024; 351:111-119. [PMID: 38286234 DOI: 10.1016/j.jad.2024.01.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Childhood maltreatment is widely acknowledged as a risk factor for developing major depressive disorders (MDDs) in adulthood. However, the influence of gender on age at MDD onset and the relationships between various forms of maltreatment remain unclear. AIMS This study aimed to evaluate the effect of gender on the relationship between childhood maltreatment and depressive disorder onset with regard to maltreatment severity, age at onset, and the correlation between different forms of maltreatment. METHODS Data for this study were derived from the Objective Diagnostic Marker and Personalized Intervention in MDD Patients (ODMPIM) study, a multi-center collaborative research project. The data used here include 1001 patients diagnosed with depressive disorder and 494 healthy participants. Childhood maltreatment levels were assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). RESULTS Emotional abuse was correlated with physical abuse, and emotional neglect was correlated with physical neglect in the MDD patient population. Emotional abuse significantly contributed to early onset of MDD in both genders. Regarding gender differences, male patients with MDD experienced more severe physical abuse during childhood. The correlation between childhood sexual abuse and physical abuse was stronger among males than among females. Levels of physical abuse and neglect tended to be positively associated with the age of MDD onset. Gender is a moderator in the relationship between MDD onset age and childhood physical abuse or neglect. CONCLUSIONS Gender plays a role in certain aspects of the relationship between MDD and childhood maltreatment.
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Affiliation(s)
- Cuizhu Dong
- Tianjin Anding Hospital and Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
| | - Zhe Wang
- Tianjin Anding Hospital and Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Feng Jia
- Tianjin Anding Hospital and Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Hongjun Tian
- Tianjin Fourth Center Hospital, Tianjin 300142, China
| | - Ying Zhang
- Tianjin Anding Hospital and Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Hong Liu
- Tianjin Anding Hospital and Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Xin Yu
- Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing 100191, China
| | - Lina Wang
- Tianjin Anding Hospital and Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
| | - Yuan Fu
- Department of Pharmacology and Tianjin Key Laboratory of Inflammatory Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China.
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Xie QW, Fan XL, Luo X, Chang Q. Mechanisms underlying the relationship between the intersectionality of multiple social identities with depression among US adults: A population-based study on the mediating roles of lifestyle behaviors. J Affect Disord 2024; 349:384-393. [PMID: 38211749 DOI: 10.1016/j.jad.2024.01.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Despite substantial efforts to investigate the inequalities in mental health among people with marginalized identities, most research has concentrated on single social identities rather than complete persons. The current study aimed to explore the mechanisms underlying the relationship between the intersectionality of multiple social identities with depression among US adults. METHODS Data for this study came from the National Health and Nutrition Examination Survey waves between 2015 and 2018, including a total of 11,268 US adults. A latent class analysis (LCA) was conducted to identify latent subpopulations based on sex, race/ethnicity, immigrant status, disability, household income, employment status, and education level. Interclass differences in lifestyle factors and depression were examined. Multiple mediation analysis was used to examine the mediating roles of lifestyle behaviors. RESULTS LCA identified four potential subpopulations: "least marginalized", "immigrant minorities", "disabled, less-educated non-workers", and "low-income minorities" groups. There was enormous heterogeneity in mental health among immigrant minority individuals. The "disabled, less-educated non-workers" group had the highest rates of depression; in contrast, the "immigrant minorities" group had the best mental health, even better than that of the "least marginalized" group. Distributions of lifestyle factors followed a similar pattern. In addition, lifestyle behaviors significantly mediated the relationship between intersectional social identities and depression. LIMITATIONS The cross-sectional design prevented establishment of the causality of relationships. CONCLUSIONS This study suggests that applying a person-centered approach is important when examining intersectional inequalities in mental health and highlights the effects of structural social hierarchies on individuals' health behaviors and mental health.
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Affiliation(s)
- Qian-Wen Xie
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China; Research Center for Common Prosperity, Future Regional Development Laboratory, Innovation Center of Yangtze River Delta, Zhejiang University, Jiaxing, China; Center of Social Welfare and Governance, Zhejiang University, Hangzhou, China; Institute for Common Prosperity and Development, Zhejiang University, Hangzhou, China
| | - Xu Li Fan
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Xiangyan Luo
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Qingsong Chang
- School of Sociology and Anthropology, Xiamen University, Xiamen City, China.
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Pan C, Liu L, Cheng S, Yang X, Meng P, Zhang N, He D, Chen Y, Li C, Zhang H, Zhang J, Zhang Z, Cheng B, Wen Y, Jia Y, Liu H, Zhang F. A multidimensional social risk atlas of depression and anxiety: An observational and genome-wide environmental interaction study. J Glob Health 2023; 13:04146. [PMID: 38063329 PMCID: PMC10704948 DOI: 10.7189/jogh.13.04146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Background Mental disorders are largely socially determined, yet the combined impact of multidimensional social factors on the two most common mental disorders, depression and anxiety, remains unclear. Methods We constructed a polysocial risk score (PsRS), a multidimensional social risk indicator including components from three domains: socioeconomic status, neighborhood and living environment and psychosocial factors. Supported by the UK Biobank cohort, we randomly divided 110 332 participants into the discovery cohort (60%; n = 66 200) and the replication cohort (40%; n = 44 134). We tested the associations between 13 single social factors with Patient Health Questionnaire (PHQ) score, Generalized Anxiety Disorder Scale (GAD) score and self-reported depression and anxiety. The significant social factors were used to calculate PsRS for each mental disorder by considering weights from the multivariable linear model. Generalized linear models were applied to explore the association between PsRS and depression and anxiety. Genome-wide environmental interaction study (GWEIS) was further performed to test the effect of interactions between PsRS and SNPs on the risk of mental phenotypes. Results In the discovery cohort, PsRS was positively associated with PHQ score (β = 0.37; 95% CI = 0.35-0.38), GAD score (β = 0.27; 95% CI = 0.25-0.28), risk of self-reported depression (OR = 1.29; 95% CI = 1.28-1.31) and anxiety (OR = 1.19; 95% CI = 1.19-1.23). Similar results were observed in the replication cohort. Emotional stress, lack of social support and low household income were significantly associated with the development of depression and anxiety. GWEIS identified multiple candidate loci for PHQ score, such as rs149137169 (ST18) (Pdiscovery = 1.08 × 10-8, Preplication = 3.25 × 10-6) and rs3759812 (MYO9A) (Pdiscovery = 3.87 × 10-9, Preplication = 6.21 × 10-5). Additionally, seven loci were detected for GAD score, such as rs114006170 (TMPRSS11D) (Pdiscovery = 1.14 × 10-9, Preplication = 7.36 × 10-5) and rs77927903 (PIP4K2A) (Pdiscovery = 2.40 × 10-9, Preplication = 0.002). Conclusions Our findings reveal the positive effects of multidimensional social factors on the risk of depression and anxiety. It is important to address key social disadvantage in mental health promotion and treatment.
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Hu J, Ji Y, Lang X, Zhang XY. Prevalence and clinical correlates of abnormal lipid metabolism in first-episode and drug-naïve patients with major depressive disorder: A large-scale cross-sectional study. J Psychiatr Res 2023; 163:55-62. [PMID: 37201238 DOI: 10.1016/j.jpsychires.2023.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/03/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE Studies have shown an association between abnormal lipid profiles and MDD, but there are few studies on the clinical correlates of lipid abnormalities in patients with major depressive disorder (MDD). The purpose of this study was to investigate the prevalence of abnormal lipid metabolism and its correlates in Chinese first-episode and drug-naïve MDD patients, which has not yet been reported. METHODS A total of 1718 outpatients with first-episode and drug-naïve MDD were included. Demographic data were collected by a standardized questionnaire and blood lipid levels were measured, including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression of Severity Scale (CGI-S) were assessed for each patient. RESULTS The prevalence of abnormal lipid metabolism was 72.73% (1301/1718), and the rates of high TC, high TG, high LDL-C and low HDL-C were 51.05% (877/1718), 61.18% (1051/1718), 30.09% (517/1718), 23.40% (402/1718), respectively. Logistic regression showed the risk factors for abnormal lipid metabolism were severe anxiety, HAMD score, CGI-S score, BMI and systolic blood pressure (SBP). Multiple linear regression analysis showed that age at onset, SBP, HAMD score, HAMA score, PANSS positive subscale score, and CGI-S were independently associated with TC levels. BMI, HAMD score, PANSS positive subscale score and CGI-S score were independently associated with TG levels. SBP, HAMD score, PANSS positive subscale score and CGI-S score were independently associated with LDL-C levels. Age of onset, SBP and CGI-S score were independently associated with HDL-C levels. CONCLUSIONS The prevalence of abnormal lipid metabolism in first-episode and drug-naïve MDD patients is quite high. The severity of psychiatric symptoms may be closely associated with the presence of abnormal lipid metabolism in patients with MDD.
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Affiliation(s)
- Jieqiong Hu
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Yunxin Ji
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - XiaoE Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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